HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /5 /S Permit Number• 150 (o-O aCo
REVIVED JUN 15 2
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
.2300 Virginia Avenue,Fart Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
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Address �-
Legal Description:
Property Tax ID#: 3414-501-1701-000/9 -41 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Replace meter center with a combo pack at each address
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AdditionalworK to be nerformed under this permit—c ec a appy:
OHVAC Gas Tank Gas Piping _Shutters Windows Doors
❑ a Windows/
Doors
Electric Plumbing ❑Sprinklers a Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor.
Cost of Construction:$ 6L60_O 0 Utilities: Sewer Septic Building Height:
Name Wynne Building Corp. Name- James W Law
Address: 8000 S US#k 1 Suite 402 Company: Law's Electric, Inc.
City: Port St.Lucie State: FL Address: 298 Beach Avenue
Zip Code: 34952 Fax: City: Port St.Lucie State: FL
Phone No. 772-878-5513 Zip Code: 34952 Fax: 772-878-3347
E-Mail: Phone No. 772-97111512
Fill in fee simple Title Holder on next page(if different E-Mail: lawselectricinc@aol.com
from the Owner listed above) State or County License: ER0000122
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: v/ Not Applicable MORTGAGE COMPANY: ✓ Not Applicable
Name- Natne-
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: j/ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address-
City: '
zip: Phone- Zip: Phone-
1 certifythat no work orinstallation has cornmenced•priorto the issuance of permit
st.Lucie Count
makes no representation that is granting apennitwill authorizethedpermit holderto build the subject structure
which is in conIct with any applicable Home Owners Asmciatlon miles,bylaws or an covenants that may restrict or problibit such
structure.Please consult wrth your Home Owners Association and review your deed for any restrictions which may apply.
In consideration ofthe granting 6f this requested permit,l do hereby agreethat I will,in all respects,perform the work
in accordance with tate approved plans,theFlorida Building Codes and St.Lucie County Amendments.
Thefollowing!wilding permit applications are exemptfrom undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses t&another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result In your paying twice for
improvements to your property-A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection.If you intend to obtain financing,consult with lender or an attorney before
commencin work or recordin our Notice of Commencement.
gnature of owner/A@enV Lesseetune of ContraetorAkense Holder
STATE OF FLORIDA - STATE OF FLORIDA
CQUNW OF SAINT WCIE COUNTY OF SAINT LUCIE,
The mg instrumentwas acimowledged before me Theforeti ng instrument was acknowledged before me
this�day of� _� _20 Lip this day.of �1.IsYl& .20�5by
,JAMES W LAW JAMES W LAW
(Name of person acknowledging) (Name of person acknowledging 1
(Si Notary Public-State of Florida) (Sign re (Notary Pu/b1'oc-State of Florida)
personally Known OR Produced Idenfification Personally Known t/ OR Produced Identification
Type of Identification Produced Type of Identification Producer!
NOTARY PUBLIC JULIE I' LAW
Commission No. EE$46506 Commission No_ EE 846906 MARY PUBLIC
ATE OF FLORIDA STATE OF FLORIDA
Comm#EE8�1B908
t F..)ltlres 40128/2016
Revised 47115/2414
RMEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SE4TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
GATE
COMPLETE
INITIALS
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